Table 1.
The difference in hand hygiene compliance in 3047 pairs of overtly and covertly observed hand hygiene opportunities stratified by department, occupation, observation time, and location
| Overt observation | Number of matched pairs (%) Covert observation |
Matched odds ratio | p valuea | |
|---|---|---|---|---|
| Hand rubbing/washing | No hand rubbing/washing | |||
| Department | ||||
| Medicine (N = 1212) | 3.0 | < 0.001 | ||
| Hand rubbing/washing | 510 (42.1) | 418 (34.5) | ||
| No hand rubbing/washing | 139 (11.5) | 145 (12.0) | ||
| Surgery (N = 1258) | 3.6 | < 0.001 | ||
| Hand rubbing/washing | 475 (37.8) | 482 (38.3) | ||
| No hand rubbing/washing | 135 (10.7) | 166 (13.2) | ||
| Paediatrics (N = 463) | 2.7 | < 0.001 | ||
| Hand rubbing/washing | 292 (63.1) | 112 (24.2) | ||
| No hand rubbing/washing | 41 (8.9) | 18 (3.9) | ||
| Gynaecology/obstetrics (N = 114) | 2.9 | 0.001 | ||
| Hand rubbing/washing | 60 (52.6) | 35 (30.7) | ||
| No hand rubbing/washing | 12 (10.5) | 7 (6.1) | ||
| Occupation | ||||
| Nurse (N = 2105) | 5.3 | < 0.001 | ||
| Hand rubbing/washing | 994 (47.2) | 778 (37.0) | ||
| No hand rubbing/washing | 146 (6.9) | 187 (8.9) | ||
| Physician (N = 619) | 1.6 | < 0.001 | ||
| Hand rubbing/washing | 241 (38.9) | 179 (28.9) | ||
| No hand rubbing/washing | 114 (18.4) | 85 (13.7) | ||
| Caregiver (N = 106) | 1.4 | 0.302 | ||
| Hand rubbing/washing | 26 (24.5) | 27 (25.5) | ||
| No hand rubbing/washing | 19 (17.9) | 34 (32.1) | ||
| Others (N = 217) | 1.3 | 0.184 | ||
| Hand rubbing/washing | 76 (35.0) | 63 (29.0) | ||
| No hand rubbing/washing | 48 (22.1) | 30 (13.8) | ||
| Timeb | ||||
| Day shift (N = 2493) | 3.1 | < 0.001 | ||
| Hand rubbing/washing | 1120 (44.9) | 838 (33.6) | ||
| No hand rubbing/washing | 273 (11.0) | 262 (10.5) | ||
| Early night shift (N = 516) | 3.7 | < 0.001 | ||
| Hand rubbing/washing | 208 (40.3) | 190 (36.8) | ||
| No hand rubbing/washing | 52 (10.1) | 66 (12.8) | ||
| Late night shift (N = 38) | 9.5 | < 0.001 | ||
| Hand rubbing/washing | 9 (23.7) | 19 (50.0) | ||
| No hand rubbing/washing | 2 (5.3) | 8 (21.1) | ||
| Location | ||||
| Ward (N = 2034) | 3.7 | < 0.001 | ||
| Hand rubbing/washing | 815 (40.1) | 774 (38.1) | ||
| No hand rubbing/washing | 208 (10.2) | 237 (11.7) | ||
| Intensive care unit (N = 880) | 1.9 | < 0.001 | ||
| Hand rubbing/washing | 498 (56.6) | 211 (24.0) | ||
| No hand rubbing/washing | 111 (12.6) | 60 (6.8) | ||
| Outpatient department (N = 133) | 7.8 | < 0.001 | ||
| Hand rubbing/washing | 24 (18.0) | 62 (46.6) | ||
| No hand rubbing/washing | 8 (6.0) | 39 (29.3) | ||
| Number of indications per hand hygiene opportunity | ||||
| 1 (N = 2301) | 3.1 | < 0.001 | ||
| Hand rubbing/washing | 963 (41.9) | 801 (34.8) | ||
| No hand rubbing/washing | 260 (11.3) | 277 (12.0) | ||
| 2 (N = 42) | 2.7 | 0.227 | ||
| Hand rubbing/washing | 28 (66.7) | 8 (19.0) | ||
| No hand rubbing/washing | 3 (7.1) | 3 (7.1) | ||
| Hand hygiene indication | ||||
| Before touching a patient (N = 270) | 3.1 | < 0.001 | ||
| Hand rubbing/washing | 96 (35.6) | 99 (36.7) | ||
| No hand rubbing/washing | 32 (11.9) | 43 (15.9) | ||
| Before clean/aseptic procedures (N = 19) | 0.063 | |||
| Hand rubbing/washing | 10 (52.6) | 5 (26.3) | ||
| No hand rubbing/washing | 0 (0) | 4 (21.1) | ||
| After body fluid exposure risk (N = 18) | 6.0 | 0.125 | ||
| Hand rubbing/washing | 8 (44.4) | 6 (33.3) | ||
| No hand rubbing/washing | 1 (5.6) | 3 (16.7) | ||
| After touching a patient (N = 287) | 3.1 | < 0.001 | ||
| Hand rubbing/washing | 140 (48.8) | 99 (34.5) | ||
| No hand rubbing/washing | 32 (11.1) | 16 (5.6) | ||
| After touching patient surroundings (N = 56) | 1.1 | 1.000 | ||
| Hand rubbing/washing | 16 (28.6) | 15 (26.8) | ||
| No hand rubbing/washing | 14 (25.0) | 11 (19.6) | ||
| Overall (N = 3047) | 3.2 | < 0.001 | ||
| Hand rubbing/washing | 1337 (43.9) | 1047 (34.4) | ||
| No hand rubbing/washing | 327 (10.7) | 336 (11.0) | ||
aMcNemar’s tests were used to analyse the differences between overtly and covertly observed hand hygiene compliance in each category
bDay shift, 0800–1600 h; early night shift, 1600–2400 h; late night shift, 2400–0800 h